When can VA Claims Agent Charge Fees for Representation?

Your claim was denied.

The letter sits on your kitchen table, official and final-looking.

Now what?

Most veterans think they need to navigate the appeals process alone. Or they assume legal help costs more than they can afford upfront.

Here’s what the VA doesn’t prominently advertise: There are specific rules about when a VA claims agent can charge for their services. And understanding these rules changes everything about how you approach your denied claim.

Let’s decode when fees for representation by agents become permissible—and when they’re absolutely prohibited.

Understanding VA Claims Agents and Their Role

What is a VA-accredited claims agent?

A VA-accredited claims agent is a professional specifically authorized by the Department of Veterans Affairs to represent veterans in their disability claims and appeals. Unlike your neighbor with good intentions, these agents have passed rigorous testing and maintain accreditation through the VA’s Office of General Counsel.

Think of accreditation like a driver’s license for VA representation.

You wouldn’t want someone without a license driving your car. You shouldn’t want someone without proper accreditation handling your claim for VA benefits.

How do claims agents differ from VSOs and attorneys?

The landscape of veterans representation includes three main players:

Veterans Service Organizations (VSOs) provide free services funded by donations and government grants. They’re like the public library of VA representation—accessible to everyone, no charge.

VA-accredited attorneys operate under state bar associations and federal court admission requirements. They’re the specialists who can represent you in federal court if needed.

VA-accredited claims agents sit between these two. They offer specialized expertise without attorney overhead costs. Many bring unique backgrounds—former VA employees, nurses, or military personnel who understand both sides of the system.

The key difference? Payment of fees for services varies dramatically between these options, particularly in proceedings before agencies of original jurisdiction.

What services do VA claims agents typically provide?

Claims agents don’t just fill out paperwork.

They interpret the complex regulations found in sources like 38 CFR 14.636, analyze your service and medical records, identify rating criteria misapplications, and craft appeals strategies based on specific legal precedents. When an agent or attorney served your case, they become responsible for understanding how the charging of fees aligns with federal regulations in proceedings before agencies of original jurisdiction.

Most importantly, they translate between two languages: the language of your lived experience and the language of VA regulatory requirements.

This translation often determines whether your appeal succeeds or fails.

Fee Restrictions Before a Notice of Disagreement (NOD)

Why are fees prohibited before the first VA decision?

Federal law under 38 U.S.C. 5904(c)(1) creates an absolute prohibition: attorneys may only charge fees after the agency of original jurisdiction has issued an initial decision on your claim.

This isn’t arbitrary bureaucracy.

It’s veteran protection legislation designed to prevent predatory practices during the most vulnerable phase of the claims process—when you’re filing for the first time and don’t yet understand the system. The regulation ensures that fees may not be charged until a veteran receives that first decision and can make informed choices about providing for payment of fees to their chosen representative.

Think of it as a cooling-off period built into federal law.

What specific work must VA claims agents perform for free?

The prohibited activities are broader than most veterans realize:

Preparing and filing initial disability claims
Gathering documents for initial submissions
Filling out VA forms for first-time applications
Providing general guidance on initial claim preparation
Any assistance related to your very first claim for VA benefits

This means that no agent or attorney may file for compensation during this phase, and the charging of fees for any initial claim assistance violates federal law. The agent or attorney is responsible for ensuring they don’t accept payment until proceedings before agencies of original jurisdiction produce an initial decision.

Collecting any fees for representation during this phase violates federal regulations and can result in loss of accreditation.

Are there any exceptions to the no-fee rule for initial claims?

None.

The prohibition is absolute for initial claims. According to M21-5 Chapter 8, there are no exceptions, exemptions, or workarounds.

Even if you desperately want to pay someone for initial claim help, agents and attorneys in proceedings before the VA cannot legally accept payment.

This is where Veterans Service Organizations become invaluable—they provide expert assistance during this phase at no cost to you.

When Fees Become Permissible

What is the significance of the Notice of Disagreement (NOD)?

The Notice of Disagreement traditionally marked the magic moment when fees may be charged for representation.

But here’s where it gets interesting.

The Appeals Modernization Act, effective February 19, 2019, changed this trigger point. Now, representatives may charge fees for representation after the agency of original jurisdiction has issued notice of an initial decision—even before you file a formal disagreement.

This means an agreement in which the agent or attorney provides services can begin earlier than in the legacy system, where a Notice of Disagreement was required before any charge fees for representation provided became permissible.

This subtle shift opens earlier representation opportunities.

How does the Appeals Modernization Act affect when fees can be charged?

The AMA created three new review lanes:

Supplemental Claims (new evidence)
Higher-Level Reviews (senior reviewer, same evidence)
Board Appeals (Veterans Law Judge review)

The AMA created three new review lanes:

Supplemental Claims (new evidence)
Higher-Level Reviews (senior reviewer, same evidence)
Board Appeals (Veterans Law Judge review)

Representatives and attorneys in proceedings before agencies of original jurisdiction can now charge fees for representation provided in any of these lanes after that initial decision. When an appellant and the agent enter into a fee agreement under AMA rules, the agent or attorney has complied with regulations that clearly specify that VA will consider the timing of services when evaluating fee reasonableness.

This means you can access paid expertise earlier in the process, potentially preventing the claim from languishing in the appeals system for years.

What date determines when a claims agent can legally begin charging fees?

The critical date is when the agency of original jurisdiction issued notice of the initial decision on your claim, provided this occurred on or after February 19, 2019.

For older claims decided before AMA implementation, the traditional NOD filing date still applies.

This date matters enormously because it determines when your attorney and the claimant can legally enter into a fee agreement. Whether the claim will be considered under legacy or AMA rules affects when fees out of past-due benefits become available to your representative.

This date matters enormously because it determines when your attorney or agent can legally enter into a fee agreement with you.

Fee Agreement Requirements and Limitations

What must be included in a valid fee agreement?

A valid fee agreement isn’t a handshake deal.

According to § 14.636 payment of fees regulations, every agreement must include:

Veteran’s name and VA file number
Claimant’s name (if different from veteran)
Specific fee calculation method
Clear description of services covered
Both parties’ signatures
Filing date with appropriate VA office

Fee agreements must also clearly specify the payment method—whether the VA will pay the agent or attorney directly or if the agent or attorney is responsible for collecting fees directly from the veteran. The agreement must also clearly specify if VA will process direct payment or if the veteran pays the claimant without assistance from VA.

What are the maximum percentage rates claims agents can charge?

Here’s where the math gets interesting:

Direct VA Payment: Maximum 20% of past-due benefits, but the fee must be entirely contingent on success. The fee which does not exceed this threshold allows for automatic payment processing.

Agent Collection: The agent or attorney is responsible for collecting fees directly from you, but attorneys may charge fees up to 33⅓% of past-due benefits before the fee is presumed unreasonable. When a contract specifies a fee greater than 20%, representatives are permitted to receive fees above the automatic payment threshold but must handle collection personally.

The key insight? Any fee agreement providing that payment exceeds 20% requires the agent to collect payment directly rather than having va is to pay the agent or attorney automatically. When an agent or attorney may enter into agreements above this threshold, they cannot rely on VA’s direct payment system.

How must fee agreements be filed with the VA?

Timing matters critically:

Direct payment agreements must be filed with the agency of original jurisdiction within 30 days of execution. The agent or attorney and must ensure proper filing to avoid payment complications.

Non-direct payment agreements go to the Office of General Counsel within the same timeframe, and the attorney and must be filed with the appropriate office based on the fee structure chosen.

Miss these deadlines, and you risk complications in payment processing. In some cases, late filing might mean benefits awarded by VA cannot be processed for direct payment, forcing collection responsibility onto the representative.

What payment structures are allowed under VA regulations?

The regulations permit three basic structures:

Contingency fees (percentage of past-due benefits)—most common for veterans and what allows representatives to be awarded directly to an agent through VA’s automatic payment system

Fixed fees (set dollar amount)—rare in VA practice because the agent will be determined to be outside direct payment eligibility when any agreement is a fee agreement that doesn’t meet contingency requirements

Hourly rates—typically combined with caps or maximums, though when attorneys may charge fees on an hourly basis they cannot receive direct VA payment

Mixed-type agreements combining contingency with fixed or hourly rates cannot receive direct VA payment. When an appellant and an agent agree to mixed payment structures or when a contract specifies a fee greater than the direct payment threshold, the services of the attorney must be collected directly from the veteran. No fee greater than 20 percent qualifies for automatic VA payment unless it meets strict contingency criteria.

This limitation pushes most attorney and agent relationships toward pure contingency arrangements.

Direct Fee Payment Options from the VA

When can the VA pay a claims agent directly?

Direct payment of fees occurs when three conditions align:

Total fee doesn’t exceed 20% of past-due benefits
Fee is entirely contingent on favorable outcome
Proper fee agreement was filed timely with agency of original jurisdiction

Think of direct payment as the VA’s preferred arrangement—it reduces collection hassles for both veterans and representatives. When va is to pay directly, both parties avoid the complications of private fee collection.

What is the 20% direct payment option?

The 20% threshold isn’t arbitrary.

It represents the VA’s determination of presumptively reasonable compensation for representation in typical cases. When fees paid directly to agents fall within this range and the agent or attorney has complied with attorney requirements in § 14.631, the VA processes payment automatically.

The veteran receives the remaining 80% without any collection responsibility, and va shall be considered to have fulfilled its providing for payment of fees obligation to both parties.

The veteran receives the remaining 80% without any collection responsibility.

How does the direct payment process work?

Once the VA approves your claim:

VA calculates 20% of gross past-due benefits
Assessment out of the fees (additional 5% up to $100) gets deducted
Net fee gets made directly to the agent or attorney
Veteran receives remaining benefits

This automation removes the awkward money conversation between veteran and representative. When benefits awarded by va shall be distributed, the payment division happens automatically according to the pre-established agreement terms.

Reasonable Fee Determinations

What factors determine if a fee is “reasonable”?

The Office of General Counsel examines multiple factors when conducting payment of fees for services reviews related to review of fees under regulatory standards:

Complexity of the case and legal issues involved
Time spent by the representative providing services
Level of skill and competence required
Results achieved for the veteran
Whether payment was contingent on success
Customary fees for similar representation

These factors matter most when evaluating whether an agent or attorney may receive compensation above the presumptively reasonable thresholds. If the OGC finds that the agent or attorney served effectively and the charging of fees was appropriate for the case complexity, higher percentages may be approved. However, any fees which exceed 33⅓% face much stricter scrutiny.

When can the VA review and reduce excessive fees?

The Office of General Counsel can review fee agreements in two ways: attorney upon its own motion when patterns suggest unreasonable charging, or when veterans file formal complaints.

The OGC’s counsel may review a fee arrangement that was initially questioned, or they may review a fee agreement to determine if terms were appropriate for the case complexity. In cases involving proceedings to review fee agreements, the OGC may approve a fee presumed unreasonable if the representative demonstrates exceptional value through detailed documentation of their review of fees under paragraph (f) analysis. However, they can also require that an agent or attorney must refund excessive portions if fees are found unreasonable.

Veterans retain the right to challenge fee arrangements throughout the entire process, and in no case may the attorney or agent prevent such challenges.

How does complexity of the case affect reasonable fee determinations?

Complex cases justify higher fees.

When your case involves multiple disabilities, complex medical evidence, or novel legal arguments, representatives may charge fees for representation at higher percentages because of increased skill and time requirements. The agent or attorney to serve complex cases must demonstrate how their specialized knowledge justifies fees above standard rates.

Simple rating increase cases might not justify fees above 20%, while complex PTSD cases with missing service records often do. However, any fee which exceeds 33 percent faces rigorous OGC scrutiny. The attorney may receive a fee above presumptive reasonableness when case complexity and agent or attorney served value clearly exceed typical representation, but they must be prepared to justify why they should may enter into a fee arrangement above standard thresholds.

Special Circumstances and Exceptions

When can a claims agent charge for expenses separate from fees?

Expenses differ from fees in important ways.

Reasonable expenses—copying medical records, postage, travel for medical exams—can sometimes be charged separately, but any fee agreement is a fee arrangement must specify these clearly to avoid confusion about what constitutes fees out of past-due benefits versus reimbursable expenses.

Most representatives avoid separate expense billing to prevent complications in their agreement in which the agent provides comprehensive services for a single contingency percentage.

Are there any situations where fees can be charged for initial claims?

Absolutely none.

Even if you insist on paying, even if the agent or attorney wants to help, even if the circumstances seem exceptional—fees may not be charged for initial claims under any circumstances.

The law protects veterans from themselves in this situation.

How do supplemental claims affect fee eligibility?

Supplemental claims create a nuanced situation.

If you file a supplemental claim as part of “continuous pursuit” of the same issue within one year, it’s not considered a new initial claim for fee purposes.

But if you file for a genuinely new condition or after a significant gap, representatives may charge fees for representation after the supplemental claim decision. However, if you seek services from another agency of original jurisdiction or file with a different regional office, the timing rules remain the same.

The key is whether your supplemental claim represents truly new evidence for an existing issue or constitutes a separate claim that would trigger new charging of fees eligibility under the regulations.

Protecting Yourself as a Veteran

What questions should you ask before signing a fee agreement?

Before any appellant and an agent enter into financial arrangements, ask:

Is this fee structure contingent on winning my case?
What happens if you withdraw or I fire you mid-case?
Are you collecting directly or requesting VA direct payment?
What specific services does this fee agreement is a fee arrangement cover?
How do you calculate “past-due benefits” for fee purposes?
Have you properly complied with all attorney requirements in § 14.631 for VA representation?

Smart veterans get clear answers before signing anything. You should also ask if the representative plans to attorney may file a response to any VA requests for fee justification and how they handle disputes about attorney or agent charge calculations.

How can you verify a claims agent is properly accredited?

The VA maintains a searchable database of all accredited representatives.

Never work with someone whose accreditation you cannot verify.

Unaccredited individuals cannot legally represent you and cannot be agent or attorney by va standards for receiving direct payment. They also cannot be awarded directly to an agent through the VA’s payment systems under any circumstances, regardless of fee agreement terms.

If someone claims they can provide representation but you cannot verify their accreditation, they cannot provide legitimate agent or attorney upon VA-approved terms.

What recourse do you have if you believe you’ve been overcharged?

You have multiple protection mechanisms:

File complaints with the VA’s Office of General Counsel
Request OGC review of fee reasonableness
Dispute the fee calculation or basis
Report unaccredited practice to VA authorities

Fee review proceedings exist specifically to protect veterans from exploitation. If you believe your representative hasn’t provided adequate services or the claimant without assistance from VA should have been able to achieve similar results, you have multiple avenues for challenging inappropriate fees.

Comparing Fee Structures: Agents vs. Attorneys

How do claims agent fees typically compare to attorney fees?

Both agents and attorneys in proceedings before the VA typically charge similar contingency percentages—usually 20% for direct payment cases.

The difference often lies in overhead and specialization. Attorneys may charge fees at higher percentages for complex cases because of their additional training and federal court admission, but agents often provide more personalized service because of smaller caseloads. When any agreement is a fee agreement that involves attorneys in proceedings before agencies, the same federal regulations apply regardless of whether the representative is an attorney or agent.

The difference often lies in overhead and specialization.

Attorneys may charge higher percentages for complex cases because of their additional training and federal court admission, but agents often provide more personalized service because of smaller caseloads.

What are the pros and cons of contingency fee arrangements?

Contingency Pros:

No upfront costs for veterans
Representative incentivized for maximum award
Responsible for collecting any fees burden shifts to representative
Risk-free for veterans

Contingency Cons:

Can create pressure for quick settlements
May the attorney or agent prioritize high-dollar cases
Less control over legal strategy decisions
Potential conflicts between veteran and representative interests

When might a fixed fee arrangement be more beneficial?

Fixed fees make sense for specific, limited services:

Document gathering for straightforward appeals
Single-issue rating increase requests
Adjudication of a claim with clear-cut evidence

But remember: attorney will be made directly responsible for collection in fixed-fee arrangements, as the VA won’t process direct payment for non-contingent fees.

The Bottom Line

The rules about when fees for services of agents become permissible aren’t just bureaucratic details.

They’re the framework that determines when you can access expert help and how much that help will cost.

Understanding these timing rules transforms your post-denial strategy. Instead of fumbling through appeals alone or assuming legal help is unaffordable, you can make informed decisions about when and how to engage professional representation.

The date on which the agent can legally begin charging fees isn’t just a regulatory milestone. When benefits awarded by va shall be distributed to both veteran and representative, this timing determines the entire financial framework of your appeal.

It’s your gateway to leveling the playing field with the VA.

Appeals for veterans claims issued after February 19, 2019, offer earlier access to paid representation through the modernized review lanes. This means you don’t have to wait for formal NOD filing to get expert help.

The difference between navigating appeals alone and having skilled representation often determines whether you receive appropriate benefits in months rather than years.

Your denied claim isn’t the end of your story.

It’s the beginning of your opportunity to access the representation rules that work in your favor.

The VA claims system wasn’t designed for simplicity, but it can be navigated with the right tools. Download our free guide: The 5 Fatal Flaws that Get Post-9/11 Orthopedic Claims Denied to understand the common pitfalls, explore our articles for deeper insights, or book a consultation to create your personalized claim strategy.

About the Author

Jerome Spearman is a VA accredited claims agent and a legal nurse consultant specializing in orthopedic appeal representation for post 9-11 veterans. He believes that every post 9-11 veteran deserves a strategic advocate who turns VA denial confusion into clarity and earned benefits. Connect with Jerome on LinkedIn or by email at jerome@spearmanappeals.com for regular updates on VA policy changes and claim strategies.

References

Department of Veterans Affairs. (2024). Tips on Fee Agreements for Veterans Claims. Retrieved from https://www.va.gov/OGC/docs/Accred/TipsonFeeAgreementsforVeteransClaims.pdf
Legal Information Institute. (2024). 38 CFR § 14.636 – Payment of fees for representation by agents and attorneys. Cornell Law School. Retrieved from https://www.law.cornell.edu/cfr/text/38/14.636
Department of Veterans Affairs. (2024). M21-5, Chapter 8, Section A – Introduction to Fees. Retrieved from https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-us/portal/554400000001018/content/554400000205495/M21-5-Chapter-8-Section-A-Introduction-to-Fees
Federal Register. (2023). Fee Reasonableness Reviews; Effect of Loss of Accreditation on Direct Payment. Retrieved from https://www.federalregister.gov/documents/2023/12/21/2023-28100/fee-reasonableness-reviews-effect-of-loss-of-accreditation-on-direct-payment
Court of Appeals for Veterans Claims. (2020). Rosinski v. Wilkie, 32 Vet.App. 264. Retrieved from https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000164990/Rosinski-v-Wilkie-Jan-30-2020-32-VetApp-264-2020
U.S. Court of Appeals for the Federal Circuit. (2024). Held v. McDonough. Retrieved from https://www.cafc.uscourts.gov/opinions-orders/23-1683.OPINION.12-9-2024_2432285.pdf
Department of Veterans Affairs. (2022). VA Memo of Major Changes July 25, 2022. Retrieved from https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-us/portal/554400000001018/content/554400000206043/VA-Memo-of-Major-Changes-July-25-2022
Veterans Benefits Administration. (2019). Appeals Modernization Brochure. Retrieved from https://benefits.va.gov/BENEFITS/factsheets/appeals/Appeals-Brochure.pdf
Department of Veterans Affairs. (2024). VA Accredited Representative FAQs. Retrieved from https://www.va.gov/resources/va-accredited-representative-faqs/
Federal Register. (2019). VA Claims and Appeals Modernization. Retrieved from https://www.federalregister.gov/documents/2019/02/15/2019-01840/va-claims-and-appeals-modernization